1831158310 NPI number — DIGESTIVE HEALTH ASSOCIATES OF TEXAS, P.A.

Table of content: DR. JOHN HENRY COLEMAN D.M.D. (NPI 1467522565)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1831158310 NPI number — DIGESTIVE HEALTH ASSOCIATES OF TEXAS, P.A.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
DIGESTIVE HEALTH ASSOCIATES OF TEXAS, P.A.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1831158310
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/19/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
7610 STEMMONS FWY
Provider Second Line Business Mailing Address:
SUITE 500
Provider Business Mailing Address City Name:
DALLAS
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
75247-4231
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
214-689-5960
Provider Business Mailing Address Fax Number:
469-713-8084

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
7610 STEMMONS FWY
Provider Second Line Business Practice Location Address:
SUITE 500
Provider Business Practice Location Address City Name:
DALLAS
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
75247-4231
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
214-689-5960
Provider Business Practice Location Address Fax Number:
469-713-8084
Provider Enumeration Date:
03/22/2006

Additional Information

Authorized Official

Authorized Official Last Name:
KIRBY
Authorized Official First Name:
GREG
Authorized Official Middle Name:
L
Authorized Official Title or Position:
EXECUTIVE DIRECTOR
Authorized Official Telephone Number:
214-689-5960

Provider Taxonomy Codes

  • Taxonomy code: 2080P0206X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207RG0100X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 126008506 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 126008505 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 100754790 A , issued by the state of ( OK ) . This identifiers is of the category "MEDICAID".
  • Identifier: 126008504 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".




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